NCG020408_MONITORING INFO_20190305

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV C(j O � D `t �
DOC TYPE
El HISTORICAL FILE
❑XMONITORING REPORTS
DOC DATE
p Oo I I 0 3 fl J
YYYYMMDD

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) - STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NC6020000
Calendar Year 2-0 i MAR 0 5 2D1
_ CEN T PiA i Clt
"Report ALL STORMWATER monitoring data on this form (include "No Flow"/"No Disc hatgeifan ,Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. N0002 M[ ®®
Facility Name: L S T odol/­,LZ t -- WAj1W_ wui e. Grp,,.^x
County:
Phone Number: ( 8) $ Y7 -- �Li Z-Total no. of SDOs monitored
Certified Laboratory C , Lab # S Gq 0
Lab #
Stormwater Discharge Outfall (SDO) No. A VMA Outfall? Yes ❑ No 0
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑/,
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, was monthly monitoring discontinued? REOF IVE❑
Yes, enough consecutive samples below benchmarks to decrease frequency El
Yes, received approval from DEMLR to reduce monitoring frequency ❑ MAR 0 5 2019
No, turbidity benchmark exceedances did not require monthly monitoring ❑ CEN WkL FILES
Other ❑ DWR SECTION
r
OutfaN No
Total
;$Rainfall,�iigll
inchesCircle
TSS,
SS,
mll(a
Turbidity;-
,NTU:`NTUa
Upstream`
U Turbidit
( } , Y,
Downstream
(D)zTuebidity;
NTIJ'°
, N' polar;
H
(VMA)
New
,Motor Oil
..
Usage'.
allma.
Stormwater
Benchmarks
indicate NO
appOWN licable
Benchmark
nctim
00I50
0'1
Benchmark
BencCirclhmark
50/25110
NIA
s andard appll s
NIA
Standard applies Water Quality
15
'Sb a requires
average requires
TSS and O G monitoringlar
Date Sample
Collectdd,, Z
molddl r'"
1
ZNB
y
7
•, rJ
F7 01
No F b vY
Permit Date 10/112015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑❑❑❑
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. VMA Outfall? Yes ❑ No ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Outfall No.
Total '
Rainfall,
inches
TSS,
mg/l
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity, •
NTU
Downstream
.(D) Turbidity,
NTU
Non -polar.
O&G, mgll
(VMA)
New
Motor Oil,
Usage
allmo.
Stormwater
Benchmarks
indicate
aFplkehle
Benchmark
Benchmark
100150
0.1
Benchmark
BencCirclehmark
50/25/10
NIA
Quality
5 Standard applies
NIA
Water ies
Standard applWater
1
0.
averagerequlres
era g regmul
TOSG mNon-polar i
Date Sample
Collected,
molddl r
Permit Date 10t112015 — 9130/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑❑❑❑
Additional Outfall Attachment (make copies as needed for additional outfalls)
Stormwater Discharge Outfall (SDO) No. VMA Outfall? Yes ❑ No ❑
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑
Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
-
Outfall No.
-'Total -
Rainfall,
inches
TSS;
mg/1
SS,' "
mill
-Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
'(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motorbil�
Usage
allmo.
Stormwater
Benchmarks
lridlcale NO
OWifCCBenchmark
a L kabla
�'"1e
Benchmark
1 D0150
0.1
Circle
50/2511 0
NIA
Standard appWater lies a
NIA
Water Qual
Standard appllea
15
�65 gaequi
average requires
d No
T08GSS nmonitoring
Date Sample
Collected,
molddl r
Permit Date 10/112015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. N0002 ❑❑❑❑
CERTIFICATION
I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Required by 40 CFR §122.22)
Signature
Date
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMI_R Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/112015 — 9130/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT DMR —WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year Z U/r
'Report ALL WASTEWATER monitoring data on this form (include "No Flow"/"No Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02 F21EOF01M
Facility Name: L13.0
County: TrAo f t /V an
Phone Number: 2 5-S'7 — q `f Z e Total no. of outfalls monitored
Certified Laboratory C y v /r a.,/- lvr e�y7-A&- T,,.c, Lab # P7� -
Lab #
Wastewater (WW) Discharge Outfall No. 0
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No [�
Does this outfall discharge WW to SA waters?
Yes ❑
No ❑
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No ❑
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No ❑
If so, what is the 7Q10 flow rate? or Tidally influenced waters,
7Q10 not available ❑
Does this outfall discharge WW to Trout jr) designated waters?
Yes &
No ❑
Were there any limit violations in the calendar year?
Yes ❑
No
Fecal
Outfall No. Daily Flow pH, TSS, SS, Discharge Upstream Downstream Coliform,
h Rate, cfs SU mgll mlll Turbidity, (U) Turbidity, (D) Turbidity, co11100 ml
it applicable NTU NTU NTU SA
Industrial Sand
HQW orORW freshwater 2J145 H
Effluent 50% of 6.0-9.0 HQw or ORIN SA, SS, PNA. No Limit NIA NIA
Limitations 7Q10 sattwater 20130 or any circle Water Water Quality Water Quality NIA
6.8-8.5 HOW orORIN 0.1I0.2 O that applies:ality Standard Standard eppliea Standard appllea
Mo. Ave I Daily Max. Indicate NO FLOW and Tr or PNA 50/25/10
it applicable 10115
Date Sample
Collected,
molddl r
Permit Date 1011/2015 — 9130/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑❑❑❑
Additional Outfall Attachment (make copies as needed for additional outfalls)
Wastewater (WW) Discharge Outfall No.
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No ❑
Does this outfall discharge WW to SA waters?
Yes ❑
No ❑
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No ❑
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No ❑
If so, what is the 7Q10 flow rate? or Tidally influenced waters,
7Q10 not available ❑
Does this outfall discharge WW to Trout jr) designated waters?
Yes ❑
No ❑
Were there any limit violations in the calendar year reported?
Yes ❑
No ❑
Outfall-No.
IDaily-Flow
Rate, cfs' 1
pH,
SU
TSS,
mgll,
SS,
milt
Napplicable
Discharge
Turbidity,,
NTU
Upstream
(U) Turbidity;
NTU
Downstream
I(D) Turbidity,
NTU
Fecal
Coliform,
col1,100 ml
'(SA)
Effluent
Limitations
Mo. Ave f Daily Max.
HQW or ORW
50% of
7Q10
Indicate NO FLOW
it applicable
freshwater
6.0-9.0
saltwater
6.8-8.5
Industrial Sand
25145
HOW orORW
20I30
HQW or ORW
and Tr or PNA
1 Oi l
HQw, oRw,
SA, SB, PNA,
or any Trout
0.1 i0.2
No Limit
circle Water
O thla applesard
$Q12511 0
NIA
Water Quality
Standard applies
NIA
Water Quality
Standard applies
NIA
Date Sample
Collected,
malddlyr
-
Permit Date 10/1/2015 - 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑❑❑❑
Additional Outfall Attachment (make copies as needed for additional outfalls)
Wastewater (WW) Discharge Outfall No.
Is this an industrial sand mine (See 40 CFR §436 Subpart D)7 Yes ❑ No ❑
Does this outfall discharge WW to SA waters? Yes ❑ No ❑
Does this outfall discharge WW to SIB or PNA waters? Yes ❑ No ❑
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout jr) designated waters? Yes ❑ No ❑
Were there any limit violations in the calendar year reported? Yes ❑ No ❑
Outfall-No.-
Daily,Fiow
Rate; cfs
pH,t
SU
TSS,
m 11
is ,SS, .
mill
if applicable
,Discharge
Turbidit
y, ty,
NTU
Upstream-
(U) Turbidity,
NTU
Downstream
(D)Turbidity,
NTU
Fecal
C;oliform;,
co11100ml
SA
Effluent
Limitations
Mo. Ave I Daily Max.
HQW or ORW
50% of
710
`+
Q
indicate NO FLOW
if applicable
freshwater
6.0-9.0
saltwater
6•8-8•5
Industrial Sand
25146
HQW orORW
20130
HQWorORW
a�tl TFr or PNA
1 0115
HQW, ORW,
SA,SB,PNA,
orrany Trout
0.1/0.2
-
No Limit
Water
Quality Standard
that applies:
5012 rJ110
NIA
Water Quality
Standard applies
NIA
WaterQua,Ity
Standard applies
N/A
Date Sample
Collected,
molddl r
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 ❑() 0[2M
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.22]
Signature
Date
Mail Annual Summary Wastewater DMR to the NCDEQ Central Office:
Note the address is correct -- Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 101112015 — 9/30/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) - STORMWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2 017
'Report ALL STORMWATER monitoring data on this form (include "No Flowl"No Discharge" and Benchmark
Exceedances) from the previous calendar vear to the DEO by MARCH 1 of rrarh veer_
Certificate of Coverage No. NCG02
Facility Name: B Al o:s — W H I T6 w^ T E n Q u �R
County: VA�v
Phone Number: Total no. of SDOs monitored
Certified Laboratory _ E h yjv.r.am Lab # 5 0 %0
Lab #
Stormwater Discharge Outfall (SDO) No. /T VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No P]
if this outfall was in Tier 2 last year, was monthly monitoring discontinued? RECEIVED
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑ MAR 0 6 2018
No, turbidity benchmark exceedances did not require monthly monitoring ❑ CENTRAL FILES
Other ❑ DWR SECTION
Outf No.
Total
Rainfall,
inches
TSS,
mgll
SS,
mill
I
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O$G, mgll
(VMA)(gal/Mo.)
New
Motor Oil
Usage
Stormwater
Benchmarks
fnClc°to NO
FLOW77
a llcablo
Circle
Benchmark
BoaGRhmark
100/50
0.1
Circle Benchmark
Benchmark
50125110
NIA
WatarQuallty
Standard applies
NIA
Waterauality
Standard applies
15
�55 a requiDaurnored
average YoqulYCe
TS8 and Nowpolar
O&Gmonitorin
Sample
Collected r
molddlyr
1 17 "1
}ktiSSsl��'iti ,!}'
�T,i,'es`d'
,I
d�l�'!•s"'•1,�}
130
}
1 �• Pit 1}
,Er��c�=
, �l T 1
i �stil�yw I
�': :�i
- l 4 t,I'
k�,tyy iI 1d
r"1:, I,; ,•.
V V 4 •' 1
1riNr I xu4r�t' t f
f
t
rDate n !.1.l 1Y 15n-
r-
W%gM 4
l•r �rY
-f
1
^{a4v
_ 6-
F uw
Permit Date 101112015 -- 913012020
Last Revised 10-2-2015

Certificate of Coverage No. N0002 OQQ®
CERTIFICATION
I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.22]
Signature
Date
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct -- Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/1/2015 — 9130/2020
Last Revised 10-2-2015

1
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL, OFFICE'
General Permit No. NCG020000
Calendar Year 20�
"Report ALL WASTEWATER monitoring data on this form (include "No FlowT'No Discharge" and Limit Violations)from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. N0002
Facility Name: L [{ A T_ o o(_ u 5 e S --
County: _TI:�.s,rs 'L V,+.4,1
Phone Number: ( t SS T '4 -e -2 Total no. of outfalls monitored
Certified Laboratory F✓tyil.aylpl..*taq l 1-t,c , Lab # 5-00
Lab #
Wastewater (WW) Discharge Outfall No. b
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No
Does this outfall discharge WW to SA waters?
Yes ❑
No ❑
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No ❑
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No ❑
If so, what is the 7Q10 flow rate? or Tidally influenced waters,
7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters?
Yes
No ❑
Were there any limit violations in the calendar year?
Yes ❑
No (�
Outfall No.
Daily Flow
Rate, cfs
pH,
SU
TSS,
mgll
SS,
mill
llrappllcable
Discharge
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Fecal
Coliform,
c011100 ml
SA
Effluent
Limitations
Ma. Ave 1 Daily Max,
HQyy or ORW
50% of
7Q10
rndreale NO FLOW
rr appt,cablo
frashwatalr�
6.0-9A
saltWWar
6•U "8.5
Industrial Sand
251,45
HQW or ORW
2U130
HQW or ORW
&aq Tr or PNA
10115
HQW, ORW,
SA, se, PNA,
oranylTrout
U r110.2
Na Limit
ClrclaWater
Quality that applies:ard
le
rJ0I2J110
NIA
Water Quality
Standard applies
NIA
Water Quality
Standard applies
NIA
Date Sample
Collected
molddl r
1p �` I
S ;t } la, �,tlti
:. «SLr�, +u_ w_I,�
a � l <
'l
�i�6�,!t.�..t:..I_�i+.:�
.r,;� ,,r• ,'
�.r� a� ��,
I` [ � , t . l
qqI 4�
P�,",-�;��r.;kl�il.
1 l 3 i
�I s1
4,..
�a! Etitt'l .�,�"�:
r�r'. ritys�t�t7I 7i �'�wr•l,
N ' W 'i id 6 iY r
l�A L G
t u �t � -- S
,I ;� �lli
�twc1�? � ���'.' �
. .Ah �A ti rt.. ,-
I�l `al s. .�t5I r ,,.i, rt r. + t t '"
ti IiPI
,h. t 4a4�• �tila;a� +, ,
i;a.iIl ,
-
ir�4 i .+
��. i � • s�,,'T ,, ..
/2 7
6 , -7
- 0, 1
At, D
10 1
1, 2
12 if-7
7.
< rl). 0
1-0r d
3. $
Permit Date 101112015 — 9/30/2020
Last Revised 10-12-2015

Certificate of Coverage No. NCG02 ©0®1
CERTIFICATION
"1 certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Required by 40 CFR §122,221
Signature
Date ,A
Mail Annual Summary Wastewater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in D WR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/1/2015 — 9130/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) -- STORMWATER
11 SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2 0 1
Report ALL STORMWATER monitoring data on this form (Include "No Flow'T'No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02
Facility Name: Lj Al _ Z -yoo y7R rc 5 .,- W H f T6 w4 7 C- R Q u ale -
County: �'If iV A-Vi---
Phone Number: Total no. of SDOs monitored 1
Certified Laboratory Lab # 50?0
Lab #
Stormwater Discharge Outfall (SDO) No. /� VMA Outfall? Yes ❑ No
Is this outfall currently In Tier 2 for any parameter? Yes ❑ No
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontinued? RECEIVE®
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑ MAR U 6 2018
No, turbidity benchmark exceedances did not require monthly monitoring ❑ CENTRAL FILES
Other
- ---- - - - ❑WR SECTION
Outf No.
Total
Rainfall,
inches
TSS,
mgll
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mgll
(VMA)
New
Motor Oil
Usage
9
gallmo.
.�t017T7iA�8Qei
Benchmarks
inClcato NO
F`°""`
a rlcablo
Circle
8anahmar6
100l50
0.1
Circle
Benchmark
50/25110
NIA
A
water Quality
Standard appllast
NIA-
Water Quality
Standard appllas
1
�58 aaume. ,w
average roqulros
ISS and Non•polor
08G monitoring
Date Sample
Collected,
molddly r
� !� �
t�: i,ll, �, 1r,
NU., j� i�
i 1. .I
�u. _, #,s<=,.�..�a
i 9>` Y
get' ,11 ;= �,
3����ih
, s14 r�
yA
1 4 � 1� �
� yy4�1!`4AI.
.{
Q IL
^few
-(vw-
t4
r--
Permit Date 10/112015 — 9/30/2020
Last Revised 10-2-2015

r
Certificate of Coverage No. NCG02 Q®a®
CERTIFICATION
I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and Imprisonment for knowing violations."
[Required by 40 CFR §122,22]
Signature
Date r
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10i112015 — 9/30/2020
Last Revised 10-2-2015

Z,
ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (I)MR) - WASTEWATER
SUBMIT TO CENTRAL OFFICE'
General Permit No. NCG020000
Calendar Year 2 017
Report ALL WASTEWATER monitoring data on this form (include "No Flow" rNo Discharge" and Limlt Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
_ - .,....,._......................... ......-............ .._.........................
Certificate of Coverage No. NCG02 ®® 0❑®
Facility Name: , A - T vi Was vie 5,
County: R•s�rs V1+1*1 _
Phone Number: { 4) SS 7— 4f�t 2 Total no. of outialls monitored j
Certified Laboratory FNt-rt.. Lab # PfgO
Lab #
Wastewater (WW) Discharge Outfati No. - 45
Is this an industrial sand mine (See 40 CPR §436 Subpart D)?
Yes ❑
No
Does this outfall discharge WW to SA waters?
Yes ❑
No ❑
Does this outfall discharge WW to SB or PNA waters?
Yes ❑
No ❑
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No ❑
If so, what is the 7010 flow rate? or Tidally influenced waters,
7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters?
Yes X
No ❑
Were there any limit violations in the calendar year?
Yes ❑
No 2�
Outfall No.
Daily Flow
Rate, cfs
pH,
SU
TSS,
mgll
SS,
mill
lrappllcable
Discharge
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Fecal
Coliform,
co11100 ml
SA
Limitations
Mo, Ave I Qalty Max.
HQW or ORW
50%of
7010
indicate NO FLOW
If applfcablu
fraahurator
6,0.9,0
Csaltwater
6.t3
P ^t3.S
industrial Sand
25145
HQW orORw
20130
NQ'V cr ORIN
D.W Tr or PNA
10115
HQW, OR"',Effluent
SA,s13,PNA,
ofunyTrout
a.110.2
No Limit
ClrcloWatvr
Quallty$tandard
that applles:
50/25/10
NIA
Waterquallty
Standardappllou
NIA
Waterquallty
StaadardnPpFlez
N/A
Sample
Collected
molddl r
l 'N;,�SA
� �,4'i�r,S! '�„i�
i
�
tt, �1q2� �,k
u$ t i
M1i1R,
� �'i. F'ti P
I r II a i
4 �Date
! �i li �
i5 jc , w
, Tr1 r A- 1 Fl •' t
•. a,
� �,! n i' s . .�
�'
r aTM . ,I
..+."
'P. ,r
l 17
0 f
1 f, 2
r7
T,1
L full)
Permit Date 10/1/2015 — 9130/2020
Last Revised 10-2-2015

FA
-
Certificate of Coverage No. N0002 ®0©®
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.221
Signature
Date 2 /7-
Mail Annual Summary Wastewater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in D WR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10i112015 -- 9/30/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR)STORMWATER�+��
„-..;, als.l ,SUBMIrT `TO,�CFN'TRAL OFFICE* i. t,•
ML1Rl17'�,,,
General Permit No. NCG020000 CENTRAL FILES
Calendar Year `
owR sEcrioN
"Report ALL STORMWATER rrionitorirlg data'on this form'(Iriclude "No Flow'),Nb=Discharde'land.Banchrrlark
M : '.: :1i S1 lT:: IrR 51' }l:}.3 l...... 1. '[. h,.. r r - , .. 1 - _.... _
�' Exceedances) from',ttie';previous'calendar;year,to the,DEQ,bi . MARCH.:fiofeachyear..r `
Certificate of Coverage No. NCG02 19©®®
Facility Name: L/vo s• - 7 Ea iLiy
County: Tr4_ ,t•j;.rL illf Zee
Phone Number. �f( .� �? 5,5"_7- �f 4<2;? Total no. of SDOs monitored r
Certified Laboratory Tic, Lab # 5'0 `l0
Lab #
Stormwater Discharge Outfall (SDO) No. A— VMA Outfall? Yes ❑ No 29
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No IN
Was this outfall ever in Tier 2 during the past year? Yes ❑ No B
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from DEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Outfal 'No
-�
_
f 1r q.'•...I-YW _w ,
Y; Totalrl ,
;Rainfall
n
i chesti�
,.,1.,, •,..n .. H.,mi.a,
TSS r .,,
m 111
g
Illla.E111S5-.,. :..n
`''SS ,,.
E.r wel
.a �w...'s.Lal
;
Tucbldlty;
,
aNTU4
Upstream„ '
M1
(U);Turbidity,
t I , `,,
,tN� DUI n w
'Downstream
, ,
�(D)k,Turbldity,,
r
NTU
`tk
r. u
Nona olar
w P:-
OS�G m 11�
g
1`/MA ' i
CC 1
i' New
iVlotor.Oih.
r
:.t. ; sage
allm o: 1 .
Stormwater•-
Benchmarks..,
t;i
-.,IndicateNO -Y
, ...' p Kati
-'Circle
,Benchmark-.
100150
- .-. - ,
, -,0.1 '
- Circle
-' Benchmark.
6012611 O .
NIA
Y, _ Standard appl es . .
NIA
,... StandeM apPlWatoriQualltlae .
S
'
">68gallmo.
average requires
TSS and Oa6 monitoring lAr
Date SampleA
Collectedm olddl rAC"+W4.5:4S:U.7
1�q
11:rrt>f LJ
IL«+ _
Q.✓k1Z1T,'�'I.SIY
�„>�
IrN?1 l., J
ft•�;,,�
YP�f�11 .Yd. li �.ii M:�
, �, 1
45
n -y;
} i�t�ii�=hA�
Permit Date 1011/2016 - 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. N0002
CERTIFICATION
I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Required by 40 CFR §122.221
Signature'L-
Date -T
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct -- Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/1/2015 — 9/30/2020
Last Revised 10-2-2015

PW
ANNUAL SUMMARY DISCHARGE MONITORING
R_E_P_ORT (DMR) — WASTEWATER
Yl• a"`�i''T.i,y Hh,,,;�zs, ,.,-.1W"r4�.�,A
,
General Permit No. NCG020000
Calendar Year 016
.Re ort'ALl- W e i} b r 4
STt=WATE ' p °evious c-'i ' ar, tear for h'el bifb$ MARCH 9 of each aear.
e „and l�imlt Violations •fro '
Certificate of Coverage No. NCG02 EI©1D
Facility Name: L. vt Giu ram' — �/j%� r t -I, u« s r
County: Tlfsx1VdV11f
Phone Number: (� d,) 5S Total no, of outfalls monitored
Certified Laboratory L �l/;.v�Wl e� fg� -,�c,- Lab # 5-09'0
Lab #
Wastewater (WW) Discharge Outfall No. Q
Is this an industrial sand mine (See 40 CFR §436 Subpart D)?
Yes ❑
No &
Does this outfall discharge WW to SA waters?
Yes ❑
No ❑
Does this outfall discharge WW to SIB or PNA waters?
Yes ❑
No ❑
Does this outfall discharge WW to HQW or ORW waters?
Yes ❑
No ❑
If so, what is the 7Q10 flow rate? or Tidally Influenced waters,
7010 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters?
Yes ®
No ❑
Were there any limit violations in the calendar year?
Yes ❑
No E4
+ 4 q' 1
'•., "�.�
Daily Flow
�, !,
'I?Hl ,
l..L l �.: li- LM 1
-', �TSS;
d ' H Y
SS l -
F �4� — f l
+ Discharge(
rIFecal
U stream
lbownstream
�•wl l
Coliform;;
lOutfr
IrN, o'"
�r kw
,, - s
Rate, cfs
lac ' +
`.SU,
��,.J', u:�.a ;
Imgllt+'
r �, , t , {
Smlll)
i t-
'Turbidity,
, , . _P,,, ��, ,,r. „
(IJ)rTurbidity,
,
(D)wTurbidity,,'rco11100
mlt
t
rtj
o
x'' l', f t
` } 4
Happ�kab`feu+
*
;lJ!
r N+
r a...
'' NT,IJS
",.
SA
l ,,N`
lU
+li'
.!,°.
+Industrial antl .
r
Effluent
HQW orORW
500% of
freshwater .
' 6.0-9.0
25145 •
HQW orORW
HQW, ORW,
SA, 80,
No•L!Wt
N/A "' "'
NIA
Limitations
TQ40
saltwater
6: A-5
2013Q,
PNA
oranySrout
0•110.2'..
Circle ifiter
Quallty Standard
WaterOuallty
Standard applies
'
Watsrcluairty,
Standard applies
N/A
Mo. Ave I Oally Max.
Date iliTi��
Indicate NO FLOW
Irappfrcabre
�
{
_
l
HQW or,0AW
and Tr or PNA•
10115
' I
���•V'.��
that appliesf
60/25/10
. .
'
a
I
j
Collected
+ '
.l.r y �
Y 'L
� �
4
�
1 �
h l
- 1��'1.
�1} II � � � tb S' 1
'a"
i^..'�4 '•�
�....7;
N
':,.
�� 'L�. O'
�•li�
r ,- molddl r .
r:,:�.�.., ..�
wA:i
�� .�.
1 v l
�;�.. �.�.,,
:F!!,a'
���.L<��l�
:Vt�... .fit
c.� ����x� .� v �
.�'
l,'�.�•;�,� •�
« ;�•
�'�!r .� • :
.4^F� ,,.„ .{
a.,l
� ,
its/rb
6.3
5;0
<0.1
by
3�23 I6
5-,
10
16,
S,U
��,�
4 0
]z17,0 1b
7
-,-5,0
-,0,1
0
Permit Date 101112015 — 9/30/2020
Last Revised 10-2-2016

Certificate of Coverage No. N0002 ❑00❑
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CPR §122.22]
Signaturew
Daie
Mail Annual Summary Wastewater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 10/112015 — 9/30/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DISCHARGE MONITORING
rREPORT (DMR) — WASTEWATER
SUBMIT TO CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year 2 01 S
a'Report ALL WASTEWATER monitoring data on this form (include "No Flow"PNo Discharge" and Limit Violations) from
the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02 MK®®
Facility Name: L d IV[ W I�+,t i-L wa *-t- r Q u a
County: Trams an, Of
Phone Number: { 1$ ) 16 6- q1 70 Total no, of oufatfal s _mon it red
Certified Laboratory C h wan wt Pre tar To C . Lab # 5090 E i1
Lab #
FES 0 5
Wastewater (WW) Discharge Outfall No. B CENTRAL FILES
DWR .S'� 'TION
Is this an industrial sand mine (See 40 CFR §436 Subpart D)? Yes ❑ No
Does this outfall discharge WW to SA waters? Yes ❑ No ❑
Does this outfall discharge WW to SB or PNA waters? Yes ❑ No ❑
Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑
If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑
Does this outfall discharge WW to Trout (Tr) designated waters? Yes No ❑
Were there any limit violations in the calendar year? Yes ❑ No Fq
Outfal No.
Daily Flow.
Rate, cfs
pH,
SU
rTSS,
mgll
:SS,
mill
it applicable
'
Discharge
Turbidity,
NTU
..
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Fecal
Coliform,
co11100 ml
(SA)
Effluent
Limitations
Mo. Ave 1 Daily Max.
Haw or ORW
50% of
7Q10
Indicate NO FLOW
it applicable
freshwater
6.0-9.0
saltwater
6.8-t3.5
Industrial Sand
25145
HQW or ORW
2V130
��
HQW or 0Rw
air d_ Tr or PNA
10115
HQW, ORw,
SA, Se, PNA,
or any Trout
a. l0, 2
No Limit
Circle Water
Quality Standard
that applies
50126110
NIA
Water Quality
Standard applies
NIA
Water Quality
Standard applies
NIA
Date Sam p!P
Collectedr
moldd! r
'>°,r'r ,. r '
r r-�
>✓ 3.i,1_
',yr'a'+t7 .
r ram
' 's x
'k9'�
qP✓'..$
ss
r�
aaF4`;Wa°
.� s` -
,firer. ;
C� .p r'" i•.>}f -
���ti,'��r�E�
.s,•T a..`
g -"HF�
SN .�,
zy 1s
4...
e-, s0
z_0,
2
a r
i;,y
-e T,
/-o,1
�s �s
6,3
C6o
-Or/
Iz/l
rro,0
e-01
Permit Date 10I112015 — 9/3012020
Last Revised 10-2-2015

I

ANNUAL SUMMARY DISCHARGE MONITORING
REPORT (DMR) -- STORMWATER
SUBMIT TO -CENTRAL OFFICE*
General Permit No. NCG020000
Calendar Year a 015
*Report ALL STORMWATER monitoring data on this form (include "No Flow" 1"No Discharge" and Benchmark
Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year.
Certificate of Coverage No. NCG02 ❑0 191®®
Facility Name: L E A4 1I/ % i te_wu*rtr 0 y a v v y
County: ? v a rs y 1 V 0+'+ isf
Phone Number: (e)-� )_ q 6 tZ 7 0 Total no. of SDOs monitored 1
Certified Laboratory C n V11rarl m *.l fad I s_ Lab # S 0 10
Lab #
Stormwater Discharge Outfall (SDO) No. _� VMA Outfall? Yes ❑ No
Is this outfall currently in Tier 2 for any parameter? Yes ❑ No �(
Was this outfall ever in Tier 2 during the past year? Yes ❑ No
If this outfall was in Tier 2 last year, was monthly monitoring discontinued?
Yes, enough consecutive samples below benchmarks to decrease frequency ❑
Yes, received approval from IDEMLR to reduce monitoring frequency ❑
No, turbidity benchmark exceedances did not require monthly monitoring ❑
Other ❑
Outfa�No.
Total
Rainfall,
inches
TSS,
mgll
SS,
mill
Turbidity,
NTU
Upstream
(U) Turbidity,
NTU
Downstream
(D) Turbidity,
NTU
Non -polar
O&G, mg/l
(VMA)
New
Motor Oil
Usage
allmo.
Benchmarks
Indicate NO
FLPWII
a iicahle
CircleStormwater Benchmark
Benchmark
100150
0.1
Benchmark
Benchmark
50/25110
N/A
water Quality
Standard applies
NIA
Water Quality
Standard applies
15
average requlrca
erale a requires
TSS and Non -polar
o8G monitoa
Date Sampler.
Collected,
molddlyr
t yRv�
aJ1;a�
j ;+�L.
�,
l7r
-
i +1
s•ipJtia a<.e!"
f
i v �,�7 t
- T 1
: .i:
/V0 FL v
Permit Date 10/1/2015 -- 9/30/2020
Last Revised 10-2-2015

Certificate of Coverage No. NCG02 lz�©®®
CERTIFICATION
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
[Required by 40 CFR §122.221
Signature
Date I /
Mail Annual Summary Stormwater DMR to the NCDEQ Central Office:
Note the address is correct — Central Files is housed in DWR (not DEMLR)
N.C. Department of Environmental Quality (DEQ)
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Central Files Telephone [phone]
Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at:
[phone]
Permit Date 1011/2015 — 9/30/2020
Last Revised 10-2-2015

ANNUAL SUMMARY DMR - STORMWATER
11 SEND TO CENTRAL OFFICE * 11
STORMWATER DISCHARGE OUTFALLS (SDO)
GENERAL PERMIT NO. NCG020000
fREDEIVED
MAR 0 4
CENTP,AL FILES
CwR SEC7.10l1,r
*Report ALL STORMWATER Monitoring Data on this form (including No Flow and No Discharge and Permit Limit Violations) by MARCH 1 of each year.
CERTIFICATE OF COVERAGE O. NCG02 0 4 0 SAMPLE COLLECTION YEAR:
FACILITY NAME: L ]3 /� To — iN , ,� l,f,a�,w Quuv�y COUNTY 1 ran S 1/ 1' V a Yt i cr
PERSON COLLECTING SAMPLES R0 11�(c �or11 �usa� rfa/l PHONE NO. (g2J) 5S 7
CERTIFIED LABORATORY _rlvl rC a Mas f r 1 T,� Lab # <5040 ADD TO LISTERVE? YES 2 NO ❑ EMAIL: tyt �a �� w1c h P e c'o (9k*7s
Lab # TOTAL RAINFALL: INCHE
EVENT DURATION: MINUTES
Part A: Stormwater Monitoring Reauirements
Outfall No.Tier
Date Sample
. Collected
(mo/ddlyr OR
NO FLOW
In Tier 2
Monthly',".#
Monitoring?
(yln)
of Months in
Ti2
z
Sampling
Total Flow
(MG)
p Total Suspended .
Solids
(mom)
d
Turbidity
(NTU)
Settleable Solids
(ml/1}
-
-
-
-
100"'
See Footnote'" 5
0.1'
Za/
A,, r* Id
S If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here and the Date Range.
Per NCG02: Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range
3 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier l or Tier 2 responses in the General Permit.
4 TSS benchmark values are 100 mg/l except in ORW, HWQ, trout, and PNA waters where they are 50 mg11.
5 The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservoirs designated
as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters; 50 NTU for all other streams and surface waters. Turbidity may be monitored at the SDO.
Alternatively, the perrnittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the SDO.
Permit Date: 1/1/2010-12/31/2014 Last Revised 01-19-10
Page I of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month on average
Outfall
No.
Date Sample
-Collected
(mo/dd/yr OR
-NO FLOW)t
In Tier 2
Monthly
Monitoring.
(y/n)
# of Months
in Tier 22
Sampling-
New Motor Oil,
Usage
(gai/month)
TotalFlow
(MG)
TPH using
method 1664A
SGT-HEM
(m }
Total Suspended
Solids,
(mg/1)
pH,
(Standard
Units)
1001
6-9'
HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEENDENCES
AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO
HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑
WHO AT THE REGION HAVE YOU SPOKEN WITH?
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW". "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCII I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, forth Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the
system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant, penalties for submitting false information, including the possibility of fines and imprisonment for knowing
violations." O/)
(Signat of Permittee)
Per ate:1/1/2010-12131/2014
z ��6 ell
(Date)
Last Revised 01-19-10
Page 2 of 2

ANNUAL SUMMARY DMR - WASTEWATER RECEIVED
SEND TO CENTRAL OFFICE' MAR 0 4 206
PROCESS MINE/DEWATERING WASTEWATER CENTRAL FILES
GENERAL PERMIT NO. NCG020000
DWR SECTION
* Report All Wastewater discharge monitoring data on this form (including No Flow and No Discharge and Pennit Limit Violations) by MARCH 1 of each year. If
you have limit violations, you must also have turned in a Limit Violation DMR to your local Regional Office within 30 days of receiving sample results from a lab.
CERTIFICATE OF COVERAGE NO. NCG02D --�t Q —g
FACILITY NAME: L RA 7T-,4fI-er'r — t/VLtIrFP �vL
PERSON COLLECTING SAMPLES: 3, elf Cer
CERTIFIED LABORATORY: Z.+r Lab#
Lab #
LIMITS VIOLATIONS? YES ❑ NO ❑
Part A: Wastewater Monitoring Requirements
SAMPLE COLLECTION YEAR: 2 O
�uari COUNTY:
a PHONE NO. (_ 2 ir)_ S� g4%12 IF
ADD TO LISTERVE? YES ❑ NO❑' EMAIL:
INDUSTRIAL SAND'? ❑ DISCHARGING TO SA WATERS;? ❑
Outfall No.
Date Sample
Collectedt
50050
Total Flow
00530
Total Suspended
Solids'
00400
Turbidity'
00545
Settleable Solids
00400
pH
31616
Fecal Coliforms
-
mm/dd/yr
MG
mg/l
NTU-
MIA
Standard
col/ml '
L� 122114
7
y a, /
E, It
' All mines must monitor WW discharges for TSS. Only industrial sand mine discharges are subject to TSS limits.
2 If an effluent limit is exceeded, the permittee is required to institute monthly monitoring for that parameter for the remaining permit term.
3 The discharge shall not cause an instantaneous measurement of the turbidity of the receiving water to exceed: 10 NTU for freshwater streams, lakes, and reservoirs
designated as trout waters; 25 NTU for all lakes and reservoirs, and all salt waters; 50 NTU for all other streams and surface waters. Turbidity may be monitored at the
Stormwater Discharge Outfall. Alternatively, the permittee may choose to monitor turbidity in the receiving water, directly upstream and downstream of the discharge.
' Only facilities discharging to SA waters are required to monitor for Fecal coliforms.
Permit Date: I/l/2010-12/31/2014 Last Revised 01-05-10
Page 1 of 2

Part A Continued: Wastewater Monitoring Requirements
Outfall No.
Date Sample
Collected t
50050
.-Total Flow
00530
Total Suspended
Solids I
00400-
","Tiirbidity;
00545
Settleable Solids
00400
pH
31616
-Fecal Coliforms
-
mm/dd/yr
MG
M01,2
NTU _
mill
Standard
col/mi '
MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW"', "NO DISCHARGE" & LIMIT
VIOLATIONS) BY MARCH I OF EACH YEAR TO:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
I am aware that there are sigpificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
�7-1 2 6 / lf
(Date)
Permit Date: 1/l/2010-12/31/2014
Last Revised 01-05-10
Page 2 of 2